Department of Justice Medicaid Fraud Control Unit Files Charges for Aggravated Illegal Appropriation of Medicaid Funds
Wednesday, August 26, 2020
(San Juan, Puerto Rico) – Acting Attorney General Inés del C. Carrau Martínez and the Medicaid Fraud Control Unit (MFCU) director, Special Prosecutor Rita Rodríguez-Falciani reported that charges were filed today against Maria J. Torres Torres, 48, a representative of Dental Health Care, LLC for Aggravated Misappropriation of funds belonging to the Medicaid Program and illegal practice of dentistry.
The investigation was conducted by Prosecutor Pedro Hernández Zumaeta together with Agent Rosalía Berenguer Zurita of the MFCU. The allegations arise from August 16, 2019, when the Puerto Rico Health Insurance Administration (ASES) and a dental services administrator, made a referral to the MFCU indicating that Maria J. Torres Torres, dental assistant and owner of Dental Health Care, LLC., a corporation that provides dental services in the Municipality of Cayey, submitted claims for payment for services allegedly provided by Dr. Gladys E. Cruz Estrada, a dentist by profession, during the months of August to December 2017. Dr. Cruz Estrada alleged and showed evidence that she never worked for Dental Health Care, LLC. The total payments for claims submitted during the period of August to December 2017, amounts to $4,199.40, coming from the Medicaid Program. The defendant during the same period served as an unlicensed dental surgeon.
Torres Torres was charged with three counts of Illegal Appropriation of Public Funds; three counts of Fraud through Electronic Means; three counts of Identity Theft and three counts of Ideological Falsehood. Torres Torres was also charged with one count of Illegal practice of the Dental profession.
The Honorable María Rojas Delgado of the Caguas Court of First Instance, found probable cause on all charges presented against Torres Torres and set bail at $13,000. The preliminary hearing will take place on September 11th, 2020.
“Funds assigned for the Medicaid Program are exclusively for the provision of health care services to indigent people in Puerto Rico as part of a matching of federal and state funds. It is unacceptable to commit fraud with these funds and we will not tolerate this type of conduct. We urge health care providers and the citizenship in general to denounce these cases. If you know of any situation that might constitute fraud against the Medicaid program or abuse and neglect against institutionalized patients, notify it at PRMFCU@justicia.pr.gov, or you can call (787) 721-2900, extensions 1551, 1560, 1561, or (787)342-5521”, concluded Acting Attorney General Carrau Martínez.
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